PIVOTALL
Research type
Research Study
Full title
Pharmacist-led intervention for atrial fibrillation in long-term care.
IRAS ID
273359
Contact name
Leona Ritchie
Contact email
Sponsor organisation
University of Liverpool
ISRCTN Number
ISRCTN14747952
Duration of Study in the UK
1 years, 6 months, 31 days
Research summary
The University of Liverpool is funding research in care homes (including both nursing and residential homes) in Liverpool and South Sefton, United Kingdom, to investigate the relationship between atrial fibrillation, frailty and treatment outcomes.
Atrial fibrillation is a heart condition that causes an irregular heart beat and it is very common in older people with frailty. Frailty is related to the ageing process. As we get older, we are more vulnerable to a sudden deterioration in health after minor events, such as a medication change.
Atrial fibrillation in older people with frailty is often under-treated because clinicians are concerned about causing more harm than good with medicines. The current gold-standard management of atrial fibrillation follows the Atrial Fibrillation Better Care (ABC) Pathway. This involves prescribing medicines to prevent strokes and provide symptom relief, as well as managing other conditions which can affect atrial fibrillation, such as heart failure and high blood pressure. It is not known how easy it is to apply the ABC pathway to older people with atrial fibrillation and frailty or whether this will improve health outcomes. This research will test this.
People aged 65+ years diagnosed with AF will be recruited. Half will have their medication reviewed and optimised by a pharmacist who will make treatment recommendations to their GPs in line with the ABC pathway, and half will not. Events including stroke, major bleeding, clots in the lungs or legs, death, hospitalisation and falls will be recorded over a 12-month period. Participants will be asked questions to assess their cognitive function, health-related quality of life, activities of daily living and symptom control. We will also measure how easy it has been to implement the pathway.
This research will be invaluable to healthcare professionals when making future treatment decisions in this high risk, vulnerable patient group.
REC name
Wales REC 4
REC reference
20/WA/0164
Date of REC Opinion
8 Jun 2020
REC opinion
Further Information Favourable Opinion